How do you get a workers compensation Case/settlement?

[devon]

I was injured almost a year ago,I had Knee surgery and got a blood clot from surgery. I was off work about 7 weeks and received workers compensation. I returned to work light duty.... My employer has treated me like crap ever since i been injured. I have been in physical theraphy for 5 months and still have not fully recovered, I still have a bllod clot.My employer and doctor is trying to force me off workers comp. So how do i qualify for workers compensation case/setlement? My medical condition is long term...

[kirklin]

Well depends on whats going on with your claim, there is more that needs to be asked here.

Is your injury so bad that you might not be able to return to usual and customary duties? What kind of knee surgery is it? How old you are? What's your job description before the injury? It also depends on what state you live in as well.

If your doctor indicates that you are unable to return to usual and customary duties than you could qualify for vocational rehab (VR). This means that work comp will pay for you to go to school to earn a certificate or an associates degree at the local community college or trade school.

You will get what's called permanent partial disability/impairment (PPD/PPI). This is your money, and it's determined by what percentages your doctor gives you for that knee. The total for PPD/PPI depends on the state and the calculations are different with some states having formulas while other states is just simple math. Typically a knee that required surgery will yield anywhere from $1500-$15,000.

So what does this all mean? Well you can close out the entire file out. If you don't want to go to school than you can settle the VR portion of the claim out. That's about $15,000 depending on your skill and your restrictions. By settling this you will also lose all indemnity rights, meaning you can't reopen or keep this portion open.

You can also settle out medical out, and this depends on the exposure you might have later in life. For instance, if you have these blood clots and you need to buy prescriptions than you'll need to know how much these drugs costs. Also if you need a knee replacement surgery later in life than you'll need to figure the cost out. Typically most medicals settle for $10,000, but in your case...it's different.

So your total settlement could be about $25,000 + you PPD/PPI value.

Here's the kicker, your settlement is also based on what you offer. Just because of these numbers are "normal" every case is different. Work comp is cruel and there are some people that don't care. In my honest opinion, if you have blood clots and there is no way of getting them out and you have to have drugs to take care of this, I wouldn't settle medical at all, this is assuming that the blood clots are a direct cause from your work injury and it's part of the claim. I would settle the indemnity and keep medicals open, and make sure it's addressed in the release forms. You might get a lower amount on your pay out, but long term wise, this might help if you are going to be on permanent blood thinners or pain pills.

If blood clots are not part of this claim and the doctors believe that the clots are there due to the surgery, you have a secondary claim, you could request that the blood clots be added to your claim. If they are not covered under work comp you might have to pay this out of your own pocket.

You have every right to get an attorney, it's up to you. If you feel that you need somebody to help you just call an attorney and they can help you. Sometimes having an attorney can help both parties.

Good luck

[thom]

Well depends on whats going on with your claim, there is more that needs to be asked here.

Is your injury so bad that you might not be able to return to usual and customary duties? What kind of knee surgery is it? How old you are? What's your job description before the injury? It also depends on what state you live in as well.

If your doctor indicates that you are unable to return to usual and customary duties than you could qualify for vocational rehab (VR). This means that work comp will pay for you to go to school to earn a certificate or an associates degree at the local community college or trade school.

You will get what's called permanent partial disability/impairment (PPD/PPI). This is your money, and it's determined by what percentages your doctor gives you for that knee. The total for PPD/PPI depends on the state and the calculations are different with some states having formulas while other states is just simple math. Typically a knee that required surgery will yield anywhere from $1500-$15,000.

So what does this all mean? Well you can close out the entire file out. If you don't want to go to school than you can settle the VR portion of the claim out. That's about $15,000 depending on your skill and your restrictions. By settling this you will also lose all indemnity rights, meaning you can't reopen or keep this portion open.

You can also settle out medical out, and this depends on the exposure you might have later in life. For instance, if you have these blood clots and you need to buy prescriptions than you'll need to know how much these drugs costs. Also if you need a knee replacement surgery later in life than you'll need to figure the cost out. Typically most medicals settle for $10,000, but in your case...it's different.

So your total settlement could be about $25,000 + you PPD/PPI value.

Here's the kicker, your settlement is also based on what you offer. Just because of these numbers are "normal" every case is different. Work comp is cruel and there are some people that don't care. In my honest opinion, if you have blood clots and there is no way of getting them out and you have to have drugs to take care of this, I wouldn't settle medical at all, this is assuming that the blood clots are a direct cause from your work injury and it's part of the claim. I would settle the indemnity and keep medicals open, and make sure it's addressed in the release forms. You might get a lower amount on your pay out, but long term wise, this might help if you are going to be on permanent blood thinners or pain pills.

If blood clots are not part of this claim and the doctors believe that the clots are there due to the surgery, you have a secondary claim, you could request that the blood clots be added to your claim. If they are not covered under work comp you might have to pay this out of your own pocket.

You have every right to get an attorney, it's up to you. If you feel that you need somebody to help you just call an attorney and they can help you. Sometimes having an attorney can help both parties.

Good luck

Well, you don't get pain & suffering with workers comp - so if that's what you mean by settlement, it doesn't exist.

Settlement means, paying off future medical bills in a lump sum, and paying off future lost wages in a lump sum. How much they're actually on the hook for, varies by state law, and can be as little as two years of lost wages.

To make it worth the insurance company's while, that lump sum would normally be DISCOUNTED, meaning, you could be left holding the bag with more medical bills than money to pay them. Many times, it's cheaper to just keep paying the bills, so they'll do that.

You can talk to your case worker/adjuster about settling, but more likely than not, you'll be screwing yourself in the long run. Workers comp benefits are pretty strictly defined by state law, so an attorney isn't going to do you much good here.